Resolving the challenges of offering a MDS service with automation

Khuram Akram is a Pharmacist and Co-Owner of Mint Pharmacy in Coatbridge on the outskirts of Glasgow. Khuram and his partner, Mubashar Khan have built their pharmacy business over the years, from providing patient services from a porta cabin in 2009, to now using advanced pharmacy technology to automate their monitored dosage system (MDS) process at their single site pharmacy. In this blog, Khuram shares why he no longer considers automation a novelty, but a necessity and a requirement in the daily operations of their pharmacy.

“Why did we decide to introduce automation to the pharmacy?

One of the things that we really pride ourselves on is the number of services that we offer to the community based on the resources that we have in the pharmacy. It’s really time consuming though and requires a lot of face-to-face patient time and this has particularly intensified throughout the Covid-19 pandemic, as Scotland introduced the Pharmacy First Plus scheme which means that pharmacy is the first point of contact for many common, clinical conditions.

On top of this we provide MDS packs for around 600 patients, so we were manually producing around 2,500 packs per month. We had 4 members of the team that constantly dispensed, filled and checked the MDS packs; this meant that nearly 25% of our workforce and an immense amount of workspace in our pharmacy was dedicated to this task. The team were stressed with the workload and we were aware that mistakes were being made due to pressures.

We were in a situation where we wanted to; remain able to provide an array services to our community, continue to thrive as a pharmacy, be prepared for future demands, to make better use of our space and to relieve intense pressures on our team and for their time to be spent on face-to-face patient care – what could help us?

Deciding on the best solution for our pharmacy

My pharmacy partner, Mubashar already knew the answer as he had been strongly suggesting the notion for the past few years – technology to automate our MDS process. We reviewed all available MDS technology on the market and after some time, we opted for the Omnicell VBM 200F. Ultimately, this machine shown to be the only solution that would help us overcome and resolve the challenges that we were up against.  

We wanted to ensure that the technology that we invested in would help balance productivity and efficiency, whilst maintaining our professional integrity. We’re the last point of contact before the patient takes their medication, so we’ve always wanted to guarantee that we were offering the best services and products to our patients. When we learnt about the VBM’s vision technology functionality, in that it takes a photo of every medication dispensed through the machine and of every completed pack, we knew this solution would help us achieve this balance. It’s actually has a really small footprint too; you can tell that it has been made to fit in the obscure environments of UK retail pharmacies!

One of our main goals that we set ourselves before the VBM machine was implemented, was to be at least one week ahead of MDS tray production, after three months of being live with the machine, as we were just about dealing with being two days ahead. This was a constant battle for us and near impossible around bank holidays and when staff were off sick. Amazingly, within the first month of using the VBM we were already hitting our one week ahead goal, which is quite impressive with the same number of staff running the machine and we were still in our learning phase.

Three months into our automation journey

We’re now three months into our journey with the VBM and we’re already seeing the benefits. We’re producing up to 30 MDS packs per hour on the machine with just one of member of staff, which means the other members of the team can now focus on more face-to-face patient services. We’re also no longer hesitant to take on more patients, we can now accept new MDS pack patients when they are requested, rather than having to go away and consider our workload or add patients to a waiting list.

Above all, we’ve noticed a substantial decrease in medication dispensing errors. When we manually produced our packs, we were making a few errors a week. Since implementing the VBM we have made three errors which were in the manual adds, in the training phase, but since then we’ve had a 0% error rate. We’re really impressed by this accurate output of the machine, especially when we found out that nearly 250,000 pills were dispensed by the VBM in September alone!

The end-product of the MDS pack is second to none. It prints the photos of the medication that are captured by the machine, includes information and dosage instructions about the medication that has been dispensed, directly on to the pack. We’ve had tremendous feedback from GPs, patients and carers that this medication overview, provides a brilliant aid and peace of mind about medication regimes.

Each MDS pack also has a unique barcode and reference number, so if patients have any queries about their medication then they can quote this, and we can easily find the photo of the completed pack on the system and answer any questions. This saves so much time for us and the patient, as without this insight we would have to ask one of our drivers to collect the MDS pack from the patient’s home, investigate with various team members and then liaise with the patient.

The team ask me ‘why did we not get this automation five years ago?’. Mubashar obviously looks quite smug when they’ve asked this, but I totally agree with them. I no longer consider technology in pharmacy a novelty, but a necessity and that’s why this is just the beginning of our automation journey.”